Background: The aim of this study was to investigate the use of autologous micrografts obtained by the Rigenera Micrografting Technology, dermal substitute and flowable wound matrix (Integra®) on injuries involving the scalp with exposed skull. For large scalp wounds with exposed calvarium, drilling of the exposed bone followed by skin grafting is usually not successful, requiring more appropriate options. Methods: The authors report their experience over 3 years of the reconstruction of extensive trauma of the head with loss of skin coverage, due to thermal, chemical and electrical burns. Results: The use of dermal template provides coverage of the defect, the application of the autologous micrografts suspension allow for faster tissue colonisation of the scaffold and neo-dermis formation, while the flowable wound matrix provide an optimal environment, resulting in a shorter interval until definitive cover by autografting. Conclusions: The authors’ protocol proved to be a good option, out of 10 consecutive patients, results were considered good or excellent in nine patients and satisfactory in one, in terms of elasticity, pliability, sensation and sweating.